Summer Challenge Application: Food & Fitness
Thank you for applying to QUESTABOX Summer Challenge: Food & Fitness this year!

Please select and make a payment for the units you're signing up for on the website (qxlearn.com). You will be receiving a confirmation email once your payment is made.  All sessions are online through Zoom and small-group based (max. 5 students in a group with a QUESTABOX teacher). Each group is usually age groups but sometimes can be mixed aged group of friends or siblings if the teacher allows.

Program Goal: Learn how to wake up, sleep better, eat healthier, and work out regularly to strengthen our immune system. We meet and work together one hour a day for 15 days this summer.

Unit Choice:
   Unit 1 (June 14 to July 2, 2021, 15 days)
   Unit 2 (July 5 to July 23, 2021, 15 days)
   Both Units
 
Age Groups (in Fall 2021) * Mixed-age groups may be available for friends and siblings.
   Grades1-3
   Grades 4-6
   Grades 7-12
   Parents

Lesson Structure:
   [5min] Wake up & Greet
   [25min] Workout
   [30min] Food Making & Nutrition
 
Prize: If you complete all 15-day challenges without missing a thing and being late, you will receive a prize!
  --  If you're a Grade 3 and younger, you will receive a QUESTABOX class credit of $80.
  --  If you're a Grade 4 and older and adult, you will receive a gift card ($50).

Sign in to Google to save your progress. Learn more
Applicant: Your full name *
Your grade level (in fall 2021) or age (if an adult) *
Parent's Full Name (if the applicant is a minor) *
Email *
Phone Number (Cell Phone) *
If you are registering as a pod (small group of max. 5 kids), please send us your group leader parent's name and his or her child's name.  If not, please skip this question. Thank you.
Your Class Time Choice *
Your Unit Choice *
QUESTABOX Agreement
[Supporting Each Student' Strengths & Needs]
 - Identifying each student's strengths and needs
 - Nourishing inquiry and potential
 - Preparing learners well for the world they will live, work, and develop in
[Building Team Spirit]
 - Growth mindset
 - Mindful learning; have a stress-free, calm, and ready to learn environment
 - No bully zone
[Disciplinary Action] QUESTABOX will promptly alert parents of any behavior by their child that is dangerous to others or disruptive to the educational environment of the class/camp. Disciplinary actions may include adaptive goal setting, behavior modification charts, removal from a situation, time outside the classroom, time away from the camp, or other similar strategies. All final decisions regarding discipline rest with the camp administration and will be communicated directly to the student’s family.
[Health comes first]  If you (applicant) are not feeling well,  we strongly recommend that you should take a good rest that day. *
Any Allergies, Special Needs, or Health Concerns *
Required
Please let us know your concerns related to your child's allergies, special needs, or health problems that our teachers should know, if any.
[Food Allergy & Restriction] There will be a hands-on food-making activity each day.  You (applicant or his her or parent) are responsible for knowing and avoiding the ingredients that he or she may have allergies. *
[Prize] The ultimate goal of QUESTABOX Food & Fitness (summer 2021) is to wake up and stay up together before our school starts in the fall. We thought prizes would be a great motivation to challenge participants. However, just in case if you end up with not receiving the prize at the end of the program, I would like you to know that your participation and not giving up are way more valuable than the prize itself.  Our teachers will be very strict about the rules and try their best to be fair for the prize system.  Anyone who completes all the 15-day challenges successfully will receive the prize.  No make-up and no refund policy for the absent sessions for any reasons.   *
Refund, Cancellation, & No Make-up Policy
1) Request for a refund must be received in writing.
2) After April 30, 2021, there will be no tuition refund. Before April 30, if you cancel, you will get refunded except for the non-refundable camp registration fee ($50).
3) No adjustment of fees if a student is withdrawn during the summer program.
4) No refund and no make-up for the absent or late classes.
5) No adjustment of fees if a student is dismissed for conduct prejudicial to the discipline and/or good name of our organization.
6) QUESTABOX reserves the right to cancel any camp or group that does not meet capacity or safety guidelines. You will be notified in advance of any cancellation. In the event a camp or group is cancelled by QUESTABOX, any registered participant will be refunded 100% of their original payment.
Liability Waiver & Photo/Video Permission
By registering and signing below, I expressly acknowledge that there are certain dangers, risks, illnesses and personal injuries inherent in participating in programs, which may result from unavoidable accidents or injuries, athletic activities, the use of any equipment, exercise, or other activities or from my or my minor child’s (children’s) physical condition. I therefore freely and voluntarily execute this release with such knowledge, assume the risk of personal injury and/or property loss arising from or in any way connected with participation in any programs offered by QUESTABOX. I hereby release and discharge QUESTABOX and any and all agents of The QUESTABOX from any liability, claim, cause of action, demand or damages from injury or damages of any kind to my child or my property as a result of participation in the programs of QUESTABOX.

Permission is hereby given for images and/or videos to be taken of my child and used for promotional and website materials through QUESTABOX. Photographed or videotaped children will not be identified by full name in our publications or on our website.

By enrolling my child in the QUESTABOX, I agree to release, indemnify and hold harmless on behalf of myself, my heirs, and representatives, QUESTABOX and its employees from any cause of action, claims, or demands of any nature whatsoever, including but not limited to a claim of negligence, which I, my heirs, and representatives may now have or have in the future against QUESTABOX, on account of any personal injury, property damage or accident of any kind arising out of or in any way related to my child’s or my enrollment in the program. Please check the box below and sign.

[Agreement & Signature] I am enrolling my child (or the applicant) in QUESTABOX Summer Challenge: Food & Fitness. I acknowledge that I have read and agree to the above terms and conditions. Please type your name. *
Today's Date *
MM
/
DD
/
YYYY
[Optional] If you're interested in signing up for other Summer Projects (June-August) or/and QUESTABOX Market 1:1 Tutoring, please visit our website or contact the Admin. Thank you!
QUESTABOX Summer Projects:    qxlearn.com,                     santaclara@questabox.com
QUESTABOX Market Tutoring:      questaboxmarket.com,    info@questabox.com
QUESTABOX Premium (Writing):  questabox.com,                help@questabox.com
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of questabox.com. Report Abuse
Google Forms